title: Biomechanic evaluation of upper-extremity symmetry during manual wheelchair propulsion over varied terrain.
abstract: OBJECTIVE
  To evaluate upper-extremity symmetry during wheelchair propulsion across multiple terrain surfaces.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A biomechanics laboratory and the general community.
  
  
  METHODS
  Manual wheelchair users (N=12).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Symmetry indexes for the propulsion moment, total force, tangential force, fractional effective force, time-to-peak propulsion moment, work, length of push cycle, and power during wheelchair propulsion over outdoor and indoor community conditions, and in laboratory conditions.
  
  
  RESULTS
  Upper-extremity asymmetry was present within each condition. There were no differences in the magnitude of asymmetry when comparing laboratory with indoor community conditions. Outdoor community wheelchair propulsion asymmetry was significantly greater than asymmetry measured during laboratory conditions.
  
  
  CONCLUSIONS
  Investigators should be aware that manual wheelchair propulsion is an asymmetrical act, which may influence interpretation when data is collected from a single limb or averaged for both limbs. The greater asymmetry identified during outdoor versus laboratory conditions emphasizes the need to evaluate wheelchair biomechanics in the user's natural environment.
authors.affiliation: College of Medicine, Department of Orthopedic Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Hurd
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Morrow
authors.forename: Kenton R
authors.initials: KR
authors.lastname: Kaufman
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D013499:Surface Properties; D013647:Task Performance and Analysis; D034941:Upper Extremity / Q000502:physiology*; D014910:Wheelchairs